Individual
MRS. ANQUINETTE LERICE MOSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MALLP
Contact information
Practice address
5555 CONNER ST, DETROIT, MI 48213-3448
(313) 308-0255
(313) 308-0270
Mailing address
5555 CONNER ST, DETROIT, MI 48213-3448
(313) 308-0255
(313) 308-0270
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-02311
MI
103TC1900X
Counseling Psychologist
6301012034
MI
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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